Collaborative Clinical Neuroscience Meeting

Boston – London – Toronto

On Friday 27th October, three of the most of the most important children’s hospitals in the western world will be meeting at Queen Square in London.

Amethyst Radiotherapy is proud to support the Boston – London – Toronto Collaborative Clinical Neuroscience Meeting lead by paediatric neurosurgeon consultant Gregory James. The conference will bring experts from Boston Children’s Hospital /Harvard University, Great Ormond Street Hospital UK and Children’s Charity and SickKids Foundation Toronto.

The session will take place at the National Hospital of Neurosurgery and Neurology with the group of clinical experts and scientists.

Great Ormond Street

Itinerary

Friday 27 October 1000 – 1630

Wolfson Lecture Theatre, NHNN

1000: Welcome and opening remarks
Greg James & Ed Smith

1015: Decision making in asymptomatic moyamoya
Greg James

1045: European Stroke Organization moyamoya guidelines
Vitor Yamaki

1130: Contribution of blood flow control at the capillary level to Alzheimer’s disease and stroke
David Attwell

1230: Lunch
Café @ 42-43 Queen Square

1315: Hot topics in moyamoya
Ed Smith

1400: Intraoperative EEG monitoring for moyamoya surgery – initial experience in London
Steward Boyd

1430: Infantile presentations of HHT
Anoushka Alwis

1500: Revascularisation surgery for AVM steal syndrome
Dulu Silva

1530: Interesting recent cases from GOSH
Dina Hanna

1600: TBC

1630: Drinks
at 42-43 Queen Square and then Queen’s Larder

eye test

How Can Routine Eye Tests Help Diagnose Brain Tumours?

A story that is rare enough to be newsworthy but common enough to appear in the newspaper is how a routine appointment or test revealed a cancerous tumour early enough for it to be diagnosed, treated and stopped.

For example, there is this story published in The Metro of a 16-year-old who went for an eye test after breaking her glasses only for the test to spot that she had medulloblastoma, and this helped her to get it treated promptly and she has since entered remission.

Whilst a wonderful story, it is important to know how these life-saving discoveries can be made, as well as what should be done as a follow-up to ensure that anyone diagnosed gets the treatment they need.

Signs An Optician Looks For

In many cases, people do not get a diagnosis for a brain tumour, growth or lesion until they start seeing symptoms and receive a referral from their GP.

This can be a problem because some forms of cancer do not demonstrate clear symptoms until they reach an advanced stage, which can limit the types of noninvasive treatment that can be done.

As most people should have an eye test every two years, there is a good chance that if there is anything to spot they will find it earlier than you might feel it in yourself.

Some vision issues that can be connected to brain tumours, besides vision loss, include:

  • The onset of recurring headaches or an ache in an odd place on the head that does not seem to go away.
  • Unusual movements, turns and blinking from the eye.
  • Double vision or blurred vision.
  • A tendency to keep the head in an unusual position, such as a head tilt, stiffness of the neck or neck pain.

Opticians usually look closely at your eyes for signs of what might have caused vision issues, and in doing so will pay close attention to the optic disc and the optic nerve.

If there is pressure on the optic nerve, it can be a sign that a tumour is putting pressure on it, whilst a swollen optic disc could be a sign of papilloedema.

If the optician finds something, they will tell you and refer you for further tests and potential treatment, depending on the nature of the growth or swelling, or whether it is a sign of a potential tumour.

Can An Eye Test Find Every Brain Tumour?

The simple answer to this is absolutely not. There are a lot of different types of brain tumours, growths and lesions, and which ones can be found through an eye test can depend on exactly where they are in the brain and what type of cancer it is.

Regardless of this, it is useful if you are concerned, and can serve as an early warning system that will allow you to receive further tests and much less invasive treatments, as the early cancer is found, the easier it typically is to treat and the more options are available for specialists.

radiotherapy

Understanding And Managing The Side-Effects Of Radiotherapy

When undergoing radiotherapy as part of your cancer treatment, it’s essential to be prepared for the potential side-effects. While they can vary depending on the type of radiotherapy, the area being treated and your individual response, it’s crucial to know what to expect and how to manage them effectively.

Common Side-Effects Of Radiotherapy

Side-effects should be expected when it comes to cancer treatment, but some are more common than others. Look out for fatigue as this is one of the most common and can begin to set in a few weeks after treatment and can be quite debilitating. To manage, plan your day to include plenty of rest breaks and make sure to stay well hydrated alongside a rich diet.

Another to look out for is skin reactions on parts of the body where treatment is occurring. It can result in red, dry or itchy patches that may peel or blister, but it is vital not to pick or agitate these as it can do more damage over time. To cope with this, use gentle skincare products and avoid tight clothing to protect these areas.

While side effects are common, some are more specialised to certain treatments as nausea or vomiting can occur if the treatment is near the abdomen or stomach. In order to handle this, look for anti-nausea medication or dietary adjustments.

For patients receiving radiation in the throat or oesophagus, swallowing issues can arise. To combat this, begin consuming soft, moist foods to make it easier throughout the process. In addition to this, staying well hydrated keeps the palate free from dryness while not eating and can help with swallowing foods when it comes time to eat.

Long-term Side Effects

While most side-effects of radiotherapy are temporary and resolve after treatment, some may persist in the long term. These can include changes in skin pigmentation, reduced range of motion in treated areas and a slightly increased risk of developing cancer in the future. It’s essential to discuss the potential long-term side-effects with your medical team.

Communication With Your Medical Team

The key to effectively managing the side-effects is open communication with your doctor. They can provide personalised guidance, recommend over-the-counter products and prescribe medications to ease symptoms. It’s vital to report any side effects promptly so that adjustments to your treatment plan can be made if necessary.

While the side-effects can be challenging, they are manageable. Knowing what to expect and maintaining open communication is essential for a smoother journey. Your doctor is there to support you and with their guidance, you can minimise the impact of side-effects and focus on your path to recovery.

Open Evening Event at Queen Square Radiosurgery Centre, London

We were honored to have Mr. Stephane Carré, CEO of the Amethyst Group, extend a warm welcome to all our esteemed guests who gathered to mark the beginning of an exciting journey in gamma knife radiotherapy treatments.

Mr. Carré highlighted the significance of this new centre and its commitment to providing cutting-edge radiotherapy solutions.

Mr. Neil Kitchen, Consultant Neurosurgeon and Medical Director at the Queen Square Radiosurgery Centre, shared insights into the current and future plans and proposals for these state-of-the-art premises. His presentation shed light on the remarkable advancements in radiotherapy technology that will benefit patients in the region.

The opening event saw a fantastic turnout, with numerous attendees coming together to explore the facility and engage in discussions about the innovative treatments and services that will be available here. It was a platform for networking and collaboration, fostering connections within the medical community.

Infrastructure implications of installing a Gamma Knife

Ian Paddick, a Consultant Physicist at specialist in radiation oncology, Amethyst Radiotherapy, discusses some of the challenges, practicalities, design considerations, and logistics, of installing a Gamma Knife radiosurgery machine into medical facilities, with a particular focus on the Queen Square Radiosurgery Centre within the University College Hospital in central London.

Read the full article here

closeup of a hand woman with a purple ribbon, for the awareness about the unacceptability of the violence against women. International Day for the Elimination of Violence Against Women.

Raising Awareness Of Breast Cancer With Brain Metastases

October is breast cancer awareness month. Throughout the month, there are a range of fund-raising activities and events taking place to support the research and treatment of breast cancer. It also encourages people to be aware of the signs and symptoms of the disease, which is the most common cancer in the UK, representing 15% of all cancers.

The majority of breast cancer patients are women, although it can affect men as well. According to Breast Cancer.co.uk, the rate of breast cancer in women has doubled over the past 50 years and a woman in the UK born after 1960 has around a 1 in 7 risk of developing breast cancer. 

86% of breast cancers in women are diagnosed at stage 1 or stage 2, which means that the cancer hasn’t spread throughout the body. Stage 4 breast cancer is known as metastatic breast cancer. Metastasis is the process of cancer cells breaking away from the original tumour and travelling to other areas of the body. 

The brain is one of the most common areas to which breast cancer spreads, occurring in around 15% to 24% of women with metastatic breast cancer (also known as secondary breast cancer). Breast cancer may also spread to the lungs, liver, and bones, either through the bloodstream or the lymphatic system. 

 

What are the symptoms of breast cancer with brain metastases?

The general symptoms that breast cancer has spread include constant tiredness, nausea, and unexplained weight loss and loss of appetite. 

Specific signs that breast cancer has spread to the brain include headache; feeling sick or being sick, weakness or numbness down one side of the body; seizures; difficulty with speech; problems with vision; confusion; memory problems; and changes in behaviour, mood, and personality.  

 

How is secondary breast cancer to the brain treated?

When breast cancer spreads to the brain, it can be treated but not cured. Treatments may involve slowing down the growth of the cancer and also relieving symptoms, and may be given alone or in combination. 

When breast cancer spreads to the brain, the cells are still breast cancer cells rather than brain cancer cells. This means that the treatment for breast cancer with brain metastases may vary from the treatments for other types of brain cancer. 

The type of treatment will depend on a range of factors, including how many tumours are present and what size they are; the location in the brain; and if the cancer has spread to any other areas of the body. 

The most common treatments include steroid drugs to reduce pressure and swelling on the brain and relieve symptoms; and radiotherapy or stereotactic radiosurgery or radiotherapy. 

Stereotactic radiosurgery is also known as Gamma Knife surgery, and it is not a conventional type of surgery involving incisions or insertions into the brain. It uses highly targeted doses of radiation from an external machine to destroy the cancer cells, whilst avoiding the healthy tissue.

Sorting pharmaceutical capsules by a sorting machine on a production line

Calls For Brain Tumour Drug To Be Made Available On NHS

Brain tumour patients and their families in the UK have called for a new drug to be made available on the NHS to treat low-grade gliomas. The Guardian reports that the drug, known as Vorasidenib, has been proved to be effective in clinical trials but is not yet used within the NHS. 

Vorasidenib works by inhibiting the enzymes IDH1 (isocitrate dehydrogenase) and IDH2 and is able to cross the blood-brain barrier, according to the The Brain Tumour Charity. A phase 3 clinical trial involving 331 patients showed that the drug significantly slowed the progression of residual or recurrent grade 2 gliomas. 

Patients who took the drug required less frequent treatments and had few side effects. It has been approved by the Food and Drug Administration (FDA) in the US and is available to be fast tracked by those patients in most need. However, it has not yet been approved for use in the UK.

The Guardian reports on the case of Shay Emerton, a 26 year old biochemistry graduate. He was diagnosed with a slow-growing grade 2 glioma in 2021. He had surgery which successfully removed 98% of the tumour, but the remaining tumour requires regular six month monitoring because there is a risk that it might regrow. 

Emerton said: “It’s so frustrating that there is something out there which could potentially help me to live a longer life and I can’t access it. They stopped the clinical trial because it was so successful.” His mum Dawn added: “People say you can wait until the drug is approved, but these patients do not have time. The tumour can progress at any stage.”

There has been widespread criticism from campaigners and researchers regarding the poor progress and funding levels for brain tumour research. 

According to the National Cancer Research Institute, since records began in 2002, £10bn of funding into cancer research in the UK has been provided, but just £126m (1.3%) has been allocated to brain tumour research.

A Department of Health spokesperson said: “Brain cancer is a devastating disease, which is why we’ve allocated £40m for research in this area, on top of £1bn a year for wider health research.”

They added: “We’ve invested in every suitable research application made and the funding will continue to be available for further studies to develop new treatments and therapies for brain tumours.”

Brain tumours are currently the biggest killer of adults under 40 in the UK, with over 12,000 people being diagnosed with a primary brain tumour each year. There are over 130 different types of brain tumour that can cause a variety of symptoms. 

These may vary from person to person, but common signs include headaches, changes in vision, seizures, nausea, dizziness, tiredness, and loss of taste and smell. Most of the time, these symptoms will have other causes, but anyone experiencing persistent or recurrent episodes of two or more symptoms is advised to consult a doctor. 

For information about treatments for glioblastoma and Gamma Knife surgery, please contact Mr George Samandouras of Amethyst Radiotherapy.

Two medical professionals examining magnetic resonance imaging scans. Examination at specialized medical clinic, diagnosis and healthcare concept.

The Brain Tumour Charity Launches Symptom Awareness Campaign

The Brain Tumour Charity has launched an awareness campaign to boost the speed of brain tumour diagnosis in adults. The Better Safe Than Tumour campaign was launched in July 2022, and the message has already reached millions of people. A specially designed symptom checker on the charity’s website has been used over 38,000 times.

If you or a loved one have been experiencing two or more of the following symptoms, you are strongly advised to get in touch with your doctor: Persistent or recurrent headaches; fatigue; seizures or fits; nausea and vomiting; loss or disturbance of vision; speech difficulties, memory problems, or loss of taste or smell.

Other common symptoms of a brain tumour include cognitive changes, and weakness, numbness or tingling of the extremities. It’s important to remember that while brain tumours are rare, they can progress quickly, so the earlier they are diagnosed and treated, the better the prognosis. 

The Better Safe Than Tumour campaign has been launched on the shoulders of the Brain Tumour Charity’s successful HeadSmart campaign, which focused on improving the speed of brain tumour diagnosis in children and young people. This has led to the average diagnosis time in the UK falling from 13 weeks to 6.5 weeks.

This is clearly a great result, and now the Brain Tumour Charity are aiming even higher with their new campaign, with a target to reduce diagnosis times to four weeks. This will bring the UK on a par with other countries who perform well in brain tumour treatment. 

Currently, 78% of people are diagnosed within three months of seeing a healthcare professional, but 42% had to visit a GP three or more times in order to get a correct diagnosis. Furthemore, 74% resorted to going to A&E with their symptoms, and 46% of patients were informed they had a brain tumour by an A&E doctor rather than a specialist.

If you would like some information about Gamma Knife surgery, please contact Mr Neil Kitchen of Amethyst Radiotherapy.

https://amethyst-radiotherapy.co.uk/conditions/brain-tumours/

The Brainstrust Brainbox: A Brain Tumour Support Toolkit

A brain tumour diagnosis can be a shocking and upsetting experience, both for the affected person and their family and friends. On top of the difficult news, there may be practical matters to think about such as financial support, employment, and childcare, at a time when you feel the least like dealing with them. 

To help people cope with these trying circumstances, the Brainstrust charity has launched a special support toolkit called the Brain Box. It contains resources that are designed to help you feel more in control of your situation, that you can turn to when you wake up feeling overwhelmed at 3am in the morning.

The boxes are free for anyone who has been diagnosed with a brain tumour or who is caring for a brain tumour patient, and they can be ordered directly from the Brainstrust website. There is the opportunity to provide details such as the age of the patient and the tumour type and grade, so that you can be sent the most relevant information.

For parents of children who have been diagnosed with a brain tumour, there is a Little Brainstrust Brainbox. Many of the resources are available online and can be downloaded.

 

What is contained in the Brain Box?

The Brain Box contains a number of different guides, and you are able to request which ones you would like to be included in your order. There is a general guide that explains the care you can expect to receive from your medical team, and a guide specifically designed for patients who are facing radiotherapy.

There are further guides covering issues such as how to cope with fatigue; how to have a difficult conversation; how to cope with behaviour and personality change; and a guide to understanding and managing the end-of-life care pathway. 

If you would like further information about brain tumour treatment, please contact Mr Andrew McAvoy of Amethyst Radiotherapy.

EU flag

Researchers Welcome UK Rejoining The EU Horizon Programme

Medical research organisations and charities have welcomed the news that the UK is to rejoin the EU’s flagship collaborative research programme Horizon. This will allow UK-based researchers to apply for grants and take part in projects under the programme, including those in under-represented areas such as brain cancer.

Britain has been excluded from the £85bn research programme since the official exit from the EU in January 2020. Previously, the UK was one of the most active participants in the programme. Although scientists have still been officially eligible to apply for funding, the process has been hugely hampered by red tape around data and cost sharing.

Now a deal has been made to allow the UK to rejoin Horizon, after a three-year delay as the Northern Ireland Brexit agreement remained mired in discussions and disagreements. The new deal is thought to be worth £2bn a year, with rebates if grants to UK scientists do not match this amount. 

Thomas Brayford, Policy and Public Affairs Manager at Brain Tumour Research, commented: “The association with Horizon is a huge win for brain tumour researchers across the country and allows them to build on years of collaborative research with their European partners.”

He added: “Importantly, it also ensures that the UK remains at the forefront of science and innovation.” Other non-EU countries, including Norway, New Zealand and Israel are also a part of the programme, and there is the possibility of Canada, Japan and South Korea joining in the future. 

Horizon is the largest medical and scientific collaborative research scheme in the world, and it allows individual nations to develop research projects at a far faster pace than they otherwise would have been able to. This is why medical research groups in particular have expressed their delight in the news that the UK is to become a full member once again.

Beth Thompson, Chief Strategy Officer of the Wellcome Trust, said: “Collaboration schemes make it a lot easier for scientists to work together across borders.”

She added: “This means really big collaborations such as the Human Brain Project, involving 500 researchers in 19 countries to help us understand how the brain works and how to address neurological problems, can take place with ease.”

“It can also mean researchers can come together to investigate things like rare diseases, at a scale that wouldn’t be possible within one country.”

“Collaboration is great for the vitality of science in the UK and elsewhere, and it’s great for new discoveries and innovation and the economy. But it’s also great for health and helping to solve the urgent health challenges the world faces.”

The news is particularly welcome for campaigners who have been calling on the UK government to improve the funding and clinical trial process into brain cancer treatment. Espite £40m over five years being allocated for this purpose in 2018, so far only £10.7m of these funds have been allocated to brain tumour research studies.

If you would like to find out more about brain cancer treatment and Gamma Knife surgery in the UK, please contact Mr Neil Kitchen of Amethyst Radiotherapy.